Operational Business Analyst

Job Description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy.

AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

PURPOSE OF THE JOB

On behalf of internal and external customers, the Operational Business Analyst will proactively identify operational inefficiencies and implement goal-oriented strategies to enhance current processes.

This role will manage operational data such as member and provider call data, claims, and enrollment information to recommend business solutions based on research and analysis.

This role will also act as a point of reference for complex financial inquiries, budgeting strategy, and financial research and analysis.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

1. Required Work Experience

• 5 years of experience in the healthcare or insurance field with emphasis on Business Analysis
• 5 years of experience in a role with a demonstrated ability to communicate with diverse groups of people inside and outside of the business
• 5 years of experience triaging complex issues from members and / or providers.
• 3 years 5 years of experience in finance, financial systems, or systems interfacing with the finance field

2. Required Education

High-School Diploma or GED in the general field of study (All Levels)

3. Required Licenses

N / A

4. Required Certifications

N / A

PREFERRED QUALIFICATIONS

1. Preferred Work Experience (All levels)

• 8 years of experience in the healthcare or insurance field with an emphasis on Business Analysis.
• 8 years of experience in a role with a demonstrated ability to communicate with diverse groups of people inside and outside the business
• 8 years of experience in finance, financial systems, or systems interfacing with the finance field
• 8 years of experience in project management

2. Preferred Education

Bachelor’s Degree in Computer Science, Information Systems, Business, or related field (All levels)

3. Preferred Licenses

N / A

4. Preferred Certifications · Business Analyst Certification (All levels)

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

Write and review business requirements, flow specifications or change requests · Conduct research and analysis for issue resolution relating to electronic transactions, customer service applications, claim adjudication systems including reporting, process efficiencies.

Track all items through to resolution.

• Provide first or second level support for internal / external customers · Utilize problem-solving skills to improve procedures and processes, resolve system deficiencies and implement enhancements
• Act as a liaison between external / internal customers and proactively collaborate and communicate with Service Operations leaders
• Provide subject matter expert (SME) advice related to identifying, researching, and analyzing operational challenges, while identifying solutions to implement.
• Facilitate and / or create new operational procedures and processes resulting from advancing technologies or capabilities.
• Lead small to medium size projects;
• Interpret design specifications for comparison against defined business needs to ensure compatibility, consistency and completeness
• Resolve differences between customers and other team members in order to achieve organizational and project goals
• Utilize existing reporting tools to develop and execute data queries for ad hoc requests; understand data source structures
• Develop complex (e.g. multiple departments / systems) business requirements on large projects and flow specifications with little to no management direction.
• Decompose high-level project information and evaluates project components to forecast work effort required
• Interpret business and technical design specifications and resolve conflicts that arise when compared against the defined needs of the business.
• Fully support all business segments
• Act as lead business analyst for large or complex projects with minimal guidance from lead or manager
• Proactively seeks opportunities to improve processes and procedures in support of customer satisfaction and corporate goals
• The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.

Participate in on-call rotation · Perform all other duties as assigned

COMPETENCIES

REQUIRED COMPETENCIES

1. Required Job Skills (Applies to All Levels)

• Strong analytical skills to support independent and effective decisions based on customer input and research
• Strong problem-solving skills
• Strong time management skills
• Basic skills with core MS products : Word, Excel, IE, Outlook, Visio, PowerPoint
• Basic skills with query tools
• Strong understanding of file handling and data translation
• Excellent verbal and written communication skills and the ability to interact professionally and maintain positive working relationships with a diverse group

2. Required Professional Competencies (Applies to All Levels)

• Prioritize tasks and work multiple priorities, sometimes under strict time constraints
• Ability to build synergy with a diverse team in an ever-changing environment
• Ability to exercise independent judgment and demonstrate creative problem-solving techniques
• Anticipates downstream impacts and factors in those considerations appropriately
• Perseverance in the face of resistance or setbacks

3. Required Leadership Experience and Competencies

• Support priorities and direction of corporate leadership
• Ability to apply sound management decision-making skills to perform effectively in the absence of management
• Effectively deal with conflict
• Ability to present concepts effectively to varying levels of staff (Applies to Levels 2 - 4)

PREFERRED COMPETENCIES

1. Preferred Job Skills (Applies to All Levels)

• Familiar with claims and customer service processes
• Formal business analyst training

2. Preferred Professional Competencies (Applies to All Levels)

• Driven to identify solutions to meet customer needs.
• Ability to work with ambiguous and conflicting information while keeping focused on the end goal.
• Performs public speaking presentations within the industry

3. Preferred Leadership Experience and Competencies

• N / A
29 days ago